Pharmacy Benefit Auditors

Pharmacy benefit auditors routinely review a pharmacy benefit plan to ensure there are no errors with the plan's administration.
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BMI Audit Services

BMI Audit Services

Reviews pending
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Company Overview

Founded

1998

Employees

0

Funding Summary

Not Provided

Clients Your Size Clients Your Size

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About BMI Audit Services

We help organizations uncover who and what healthcare dollars are being spent on by digging into benefits data and verifying if:

- the right people are enrolled in the plan
- healthcare claims are accurate per plan design

At BMI, we understand the concerns you may have about whether third-party administrators are accurately processing healthcare claims or if enrolled members are truly eligible for their benefits. Our auditing services provide a comprehensive solution to ensure the integrity of your health plan and to guarantee fair and accurate benefits for all members. Additionally, our... Show More
Bluespine

Bluespine

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Min. Group Size

-

Lives Serviced

1,200,000

Average Cost

Average Cost is Locked

0 RFI Questions Get access to vendor answered question RFIs.

RFI questions number is Locked

5 Specific Questions Specific Questions

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Product Features

✓

Pricing audits

 ✓

Fraud waste and abuse audits
✓

Eligibility audits
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Not Provided.

Product Description

Bluespine reviews 100% of pharmaceutical claims prepayment to ensure plan design, policy, and pricing accuracy before payment is made. Bluespine can also retrospectively review a batch of claim post-payment and recovery overpayment findings... Show More
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MedBill Management

MedBill Management

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Min. Group Size

-

Lives Serviced

-

Average Cost

Average Cost is Locked

0 RFI Questions Get access to vendor answered question RFIs.

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5 Specific Questions Specific Questions

Lock

Product Features

✓

Rebate audits

 ✓

Pricing audits
✓

Fraud waste and abuse audits

 ✓

Eligibility audits
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Not Provided.

Product Description

>>>Pharmacy Claims Audits assess the accuracy of prescription drug claims payments in the same precise and comprehensive manner as our Medical Claims Audits. Pharmacy Claims Audits analyze the Pharmacy Benefit Manager’s (PBM) compliance... Show More
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Truveris

Truveris

4.5 (1)
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Min. Group Size

-

Lives Serviced

-

Average Cost

Average Cost is Locked

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Lock

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Ongoing Pharmacy Oversight: Truveris offers independent pharmacy benefit oversight through comprehensive monitoring of pharmacy claims throughout the PBM contract lifecycle. Our solution systematically validates PBM performance against contract terms, ensuring compliance and identifying... Show More
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Crumdale Partners

Crumdale Partners

5.0 (1)
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Founded

2014

Employees

0

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Not Provided

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About Crumdale Partners

Crumdale Partners is a diversified insurance firm providing custom, self-funded healthcare solutions to a bespoke set of brokers, consultants, and agents nationwide. We optimize the fragmented health benefits supply chain to reduce health benefit costs and create better outcomes for employers and employees. We sell integrated and unbundled solutions to brokers looking for flexibility in their self-funded and level-funded health plans, pharmacy benefits, stop-loss, actuarial and compliance needs.­ Show More
Exouza

Exouza

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Founded

2019

Employees

0

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About Exouza

Exouza was founded by health and technology industry experts to leverage modern technology to develop a single platform that maximizes the value of member benefits to integrate all available programs in a single platform that quickly and efficiently improves the process of managing health and Rx delivery. Exouza's technology quantifies the value from each member's eligible program, sequences engagement in prioritized order, and manages participation so that the member and employer achieve maximum value. Each member and drug experience is different which makes the Exouza solution unique. Savings service and value are guaranteed.
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Integrated Prescription Management

Integrated Prescription Management

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Founded

2009

Employees

0

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Not Provided

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About Integrated Prescription Management

IPM is now part of LucyRx

Integrated Prescription Management (IPM) is a full-service pharmacy benefits manager (PBM) that works with self-funded employer groups, brokers, and TPAs around the country. Known for our high-touch service, insightful analytics, and flexible benefit designs, we take a collaborative approach to controlling costs without compromising care. Show More
Kelly Benefits

Kelly Benefits

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Min. Group Size

-

Lives Serviced

-

Average Cost

Average Cost is Locked

0 RFI Questions Get access to vendor answered question RFIs.

RFI questions number is Locked

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Lock

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Will not complete per Corp Comm 1.8.24 Show More
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Remedy Analytics

Remedy Analytics

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Founded

2013

Employees

0

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About Remedy Analytics

Remedy’s mission is to make prescription drugs more affordable and accessible for self-insured payors and patients for optimal health. It was built on the premise that in order to understand the true cost of a prescription drug and its utilization, access to data that every claim generates is essential, along with sophisticated analytics necessary to agnostically understand – and act on -- that data. Show More
RxResults

RxResults

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Founded

2008

Employees

0

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About RxResults

RxResults, the proven industry leader for Evidence-Based Pharmacy Risk Management, is uniquely positioned to help you identify health plan savings and mitigate risk.

A Pharmacy Risk Manager doesn't replace a PBM. It serves to enhance a PBM model as an advocate for the plan sponsor and its plan participants. Show More

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